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General NPI Number Information
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NPI Number | 1750644746
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Entity Type | Organization
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Legal Business Name | ERCA LITTLE ELM LLC
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Dates
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Enumeration Date | 06/24/2012
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 2700 E ELDORADO PKWY STE 104
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City | LITTLE ELM
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State | TX
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Zip | 75068-0000
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Country | US
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Telephone | 972-987-4395
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Fax | 972-987-4768
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Provider Business Mailing Address
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Address Line | 6501 PRESTON RD STE 102
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City | PLANO
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State | TX
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Zip | 75024-2610
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Country | US
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Telephone | 972-403-1155
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Fax | 972-608-0844
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Authorized Official
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Title or Position | MANAGER/COO
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Name | MR. JOHN A MCGEE
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Credential |
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Telephone | 214-619-2060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 160056
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License Number State | TX
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